SLIDE 1
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17th Multidisciplinary Management of Cancers: A Case‐based Approach
Case 1: California’s End of Life Options Act
- Mrs. Mobitz is 75 years old and was diagnosed one month ago with squamous cell
carcinoma of the lung. She is not interested in chemotherapy or immunotherapy, and would like the option of ending her life on her terms. She seems to interact normally with you, and does not appear to be clinically depressed – rather, she is resigned.
17th Multidisciplinary Management of Cancers: A Case‐based Approach
Case 1: California’s End of Life Options Act
- Mrs. Mobitz is 75 years old and was diagnosed one month ago with squamous cell
carcinoma of the lung. 1.1) Her husband asks: “Is she eligible for the pill?”
- a. Yes, because she has less than six months, meeting the “definition” of terminal illness.
- b. Yes, if she continues to show evidence of having “capacity”.
- c. Yes, if there is no good evidence of depression or anxiety interfering with her judgment.
If present, this require evaluation by a psychiatrist or clinical psychologist.
- d. Yes, if she asks now, and again at least 15 days from today, and signs the “Attestation”
form (thereby providing a written request).
- e. All of the above
- f. Not of the above
17th Multidisciplinary Management of Cancers: A Case‐based Approach
EOLA California Requirements:
- Attending physician and consulting physician have diagnosed the patient with terminal
illness with six month or less life expectancy
- Patient has voluntarily expressed a desire to receive aid‐in‐dying medication
- Patient has the mental capacity to make and communicate healthcare decisions
- Patient is a resident of California
- Patient is at least 18 years old
- Patient has the physical ability to self‐administer and swallow the aid‐in‐dying
medication
- Applicable documentation must be completed by patient’s attending and consulting
physician
17th Multidisciplinary Management of Cancers: A Case‐based Approach
Case 1: California’s End of Life Options Act 1.2) You say, “ What makes you ask for something like this?” She answers that she does not want to die in terrible pain. How might you respond?
- a. Most cancer patients don’t die in terrible pain.
- b. We have lots of good pain medications
- c. Getting on to hospice care opens the door to having the focus of care be pain and
symptom management, and that hospice nurses are experts in this.
- d. Point out that for patients with intractable pain, “palliative sedation” brings state of
unconsciousness, so they don’t feel any pain.
- e. All of the above.